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MANGROVE WELLNESS CENTER,INC
NPI 1285987453
Counselor - Mental Health in Venice, FL

Active since October 24, 2012
1515 TAMIAMI TRAIL S., SUITE 2, VENICE, FL 34285(941) 822-5620(855) 239-0365 Get Directions Write a Review

NPPES record last updated: October 13, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mangrove Wellness Center,inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANGROVE WELLNESS CENTER,INC (NPI 1285987453) is a healthcare organization registered as a mental health in Venice, Florida and active in the NPI registry since October 2012. The organization lists Lisa Reidsema, President, as its authorized official.

NPPES Registry Identity

NPI1285987453
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameMANGROVE WELLNESS CENTER,INC
Location Address1515 TAMIAMI TRAIL S., SUITE 2Venice, FL 34285
Mailing Address1515 Tamiami Trail S., Suite 2Venice, FL 34285 · (941) 822-5620 · Fax (855) 239-0365
Phone(941) 822-5620
Fax(855) 239-0365
Organization SubpartNo
Authorized OfficialLisa ReidsemaPresident · (941) 822-5620
Enumeration DateOctober 24, 2012
Last NPPES UpdateOctober 13, 2014
✔ NPI 1285987453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH12785
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License MH12785 (FL), PY5867 (FL)
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PY5867 (FL)
1515 TAMIAMI TRAIL S., Venice, FL 34285
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mangrove Wellness Center,inc's NPI number?

The NPI number for Mangrove Wellness Center,inc is 1285987453. It was assigned to this organization in the NPPES registry on October 24, 2012.

Where is Mangrove Wellness Center,inc located?

Mangrove Wellness Center,inc is located at 1515 Tamiami Trail S. Suite 2, Venice, FL 34285. The listed phone number is (941) 822-5620.

What is Mangrove Wellness Center,inc's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mangrove Wellness Center,inc was last updated on October 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.